CPT® Code 84233

Official Description

Receptor assay; estrogen

Common Language Description

A receptor assay is a laboratory test conducted to evaluate the presence of specific hormone receptors on tumor cells, which is crucial in determining the potential effectiveness of hormone therapy for cancer treatment. In the context of CPT® Code 84233, the focus is on the estrogen receptor assay, specifically performed on breast cancer cells. This assay assesses whether estrogen receptors are present on the cancer cells, which is significant because normal breast cells, as well as certain breast cancer cells, can be influenced by estrogen. Estrogen receptors are specialized proteins that bind to estrogen circulating in the bloodstream, facilitating communication that influences cell growth and reproductive functions. When breast cancer cells are classified as estrogen receptor positive, it indicates that these cells possess estrogen receptors and are likely to respond favorably to hormone therapies, which may include anti-estrogen medications or surgical interventions such as oophorectomy (removal of the ovaries). Conversely, breast cancer cells that are estrogen receptor negative lack these receptors and typically do not respond well to hormone therapy, making the receptor assay a vital component in guiding treatment decisions. This distinction is essential for tailoring effective treatment strategies for patients with breast cancer, as it directly impacts the choice of therapeutic options available to them.

1. Indications

The estrogen receptor assay (CPT® Code 84233) is indicated for the following conditions:

Breast Cancer Diagnosis The assay is performed to determine the presence of estrogen receptors in breast cancer cells, which is critical for assessing the potential response to hormone therapy.
Treatment Planning The results of the assay help guide treatment decisions, particularly in selecting appropriate hormone therapies for patients with estrogen receptor positive breast cancer.
Prognostic Assessment The assay aids in evaluating the prognosis of breast cancer by identifying the receptor status, which can influence the expected outcomes of hormone therapy.

2. Procedure

The procedure for conducting an estrogen receptor assay involves several key steps to ensure accurate results:

Sample Collection A sample of breast cancer tissue is obtained, typically through a biopsy or surgical resection. This sample is essential for analyzing the presence of estrogen receptors.
Preparation of Tissue Sample The collected tissue is processed in the laboratory, where it is fixed and embedded in paraffin to preserve the cellular structure for examination.
Immunohistochemical Staining The prepared tissue sections are subjected to immunohistochemical staining, where specific antibodies that bind to estrogen receptors are applied. This step allows for the visualization of receptor presence under a microscope.
Microscopic Evaluation A pathologist examines the stained tissue sections under a microscope to determine the presence and quantity of estrogen receptors. The results are categorized as positive or negative based on the staining intensity and distribution.
Reporting Results The findings from the assay are compiled into a report, which includes the receptor status and any relevant observations that may impact treatment decisions.

3. Post-Procedure

After the estrogen receptor assay is completed, the results are typically reviewed by the treating physician in conjunction with other diagnostic information. Patients may be informed of their receptor status, which plays a crucial role in determining the most effective treatment plan. If the assay indicates that the breast cancer is estrogen receptor positive, the physician may discuss potential hormone therapies, such as anti-estrogen medications or surgical options. Follow-up appointments may be scheduled to monitor the patient's response to treatment and adjust the therapeutic approach as necessary. Additionally, patients may be advised on any further testing or evaluations that may be required based on their overall treatment strategy.

Short Descr	ASSAY OF ESTROGEN
Medium Descr	ASSAY OF RECEPTOR ASSAY ESTROGEN
Long Descr	Receptor assay; estrogen
Status Code	Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
CLIA Waived (QW)	No
APC Status Indicator	Conditionally packaged laboratory tests
Type of Service (TOS)	5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS)	T1H - Lab tests - other (non-Medicare fee schedule)
MUE	1
CCS Clinical Classification	233 - Laboratory - Chemistry and Hematology

Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.